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In manufacturing, 3D printing has been used to create realistic prototypes. Now increasingly the technology is being used in medicine to create replica bone and organ structures to train surgeons. One project, led by researchers at Nottingham Trent University is 3D printing replicas of the human spine to train surgeons before they enter the operating theatre.

Researcher Joe Meeks, MSc student at Nottingham Trent University, states that the aim of the project is “to provide consultants with a realistic representation of spinal surgery which allows them to learn in a safe and calm environment” which would both “improve the skills of surgeons” and “enhance operative outcomes for patients in real life”.

A 3D printed single vertebra. The outer cortical bone is 3D printed PLA while the inner cancellous bone is made of sponge. Photo via Nottingham Trent University.

3D printing with a backbone

The models are 3D printed in PLA and a binding agent. The components are then post processed, varnished with polyester, a soft polyurethane is inserted into the centre of the spinal structure, and then joined with spinal disks made of silicone.

Joe Meeks explains how the structure model reflects the composition of the human spine, “there are two kinds of bone, the inside [of the model] is made of of foam, which represents the softer cancellous bone, and then there’s harder outer cortical bone, which we will 3D print”.

Procedures that may be performed on the spinal replicas include laminectomies, trapped nerve relief, and the removal of bone tissue. For other conditions, such as scoliosis, which results a deformed spine, individual models may be 3D printed from CT scans.

Realistically simulating a delicate process

Surgery on the spine is an extremely risky procedure. Prof. Philip Breedon, from the university’s Design for Health and Wellbeing Group at Nottingham Trent says that “one error can lead to catastrophic, life-changing consequences for a patient, so it’s imperative that surgeons can prepare themselves thoroughly”.

He explains that, to address the issue, “this research will enable clinicians to experience how performing spinal surgery feels both physically and mentally, but in a safe training environment.”

Prof. Bronek Boszczyk, consultant spinal surgeon at the the Nottingham University Hospitals Trust, with whom the project is in conjunction, praises the realism of the bones, adding that “these models will enable surgeons to practice very delicate procedures in a training environment which will give clinicians increased confidence before they undertake real spinal operations.”

California-based Spinal Elements has already used 3D printing to prepare surgeons for spinal operations on individual patients with PEEK models, while Virgina-based K2M have produced 3D printed implants for correcting spinal defects.

The next stage for the Nottingham Trent researchers will be to print replica bones with varying strength. This will give surgeons an accurate experience of operating on people with bone strength diseases like osteoporosis. The research will eventually be used to train surgeons in the classroom.